During surgery, tissues often have to be mobilized and displaced in order to obtain optimal exposure of the affected area or organ. In traditional surgical procedures, the affected organ or area is exposed using a relatively large incision, typically in the chest or abdomen. For example, in many traditional open heart surgical procedures, the chest cavity is opened and the ribs retracted to expose the heart. When a large incision is made, exposure of the organ or tissue to be operated upon is seldom a critical factor, i.e., it is comparatively easy to immobilize or displace intervening tissues to expose the target area. If an artery ruptures or a similar urgent problem arises that requires access to the organ, the organ is already exposed to a sufficient extent to deal with the complication.
In recent years, however, surgeons have turned to endoscopic techniques to reduce the trauma associated with traditional surgical methods. In particular, methods have been proposed for performing operations on heart tissues without opening the chest. See Johnson U.S. Pat. No. 5,306,234. Methods have also been proposed for performing bypass operations without opening the chest, as described in Sterman et al. U.S. Pat. Nos. 5,571,215 and 5,452,733. In endoscopic surgery, in which a relatively small incision is made and an observation device is inserted into the body and relied upon to guide the surgery, effective exposure of the target tissue or organ becomes more critical.
According to conventional practice, after an incision is made, soft tissues such as bowel or lung are displaced with broad, flat retractors. In some cases, traction is required to retain the tissue in order to obtain exposure of the organ or area where the surgery is to be performed. Retraction is usually accomplished by clamping the tissue (i.e., bowel, gall bladder, atrium) with a "a traumatic clamp". The clamp is then used to pull the tissue in whatever direction is necessary to obtain the required exposure. No clamp is, however, truly a traumatic. Crushing a piece of tissue always causes at least mild tissue damage. If the tissue to be clamped and/or retracted is inflamed or tense, clamping is even more likely to result in tissue damage, including perforation of the tissue. Thus, there exists a need for an improved device and method for mobilizing and displacing soft tissue during surgical procedures, in particular during endoscopic surgical procedures, that provides traction without the trauma associated with traditional surgical clamps.
A device according to the invention that meets this need uses suction as described in detail hereafter to mobilize and displace soft tissue. Suction applied through tubular devices inserted into the body has long been used as a means of removing unwanted fluids during surgery. Benetti et al. U.S. Pat. No. 5,727,569 describes devices which use negative pressure during open heart surgery to immobilize cardiac tissue during surgery which include a ring-shaped device and a hand-held device resembling a pair of tongs. A need nonetheless persists for a device for manipulating soft tissue that is simple, easy to use and control, and which can be used in endoscopic surgery.